From Associated Press: Kim Clijsters says her recent hip injury has been helped by acupuncture.

Tara Parker-Pope has published an interesting article in the New York Times health blog discussing why conclusive scientific proof of acupuncture’s efficacy is difficult to achieve. I believe the crux of the problem lies in the differing philosophical approaches underlying modern evidence-based medicine and acupuncture.

Evidence-based medicine is necessarily a reductionist approach, where ideally, every therapeutic modality is analysed and broken down to it’s component parts, with each part then analysed for efficacy (usually with the ‘gold’ standard Randomised Controlled Test), to yield the simplest therapeutic quantum that can produce measurable, scalable and repeatable results.

Acupuncture, or at least ‘traditional acupuncture’ as opposed to ‘medical acupuncture’, is a holistic approach, treating the entire person in the context of their emotional and physical environment. Acupuncture is a complex interaction with the whole organism, with different people experiencing different effects and reactions. Such a complex interaction is difficult to reduce to a simple standard set of points for a given condition, so the randomised controlled test is probably not a suitable tool to use to interpret the effects of acupuncture. This is why we often see studies published that contradict each other. The same thing applies to other therapies that interact with the body in a complex way.

At present medical reductionism rules, at least as far as the medical establishment is concerned, where unfortunately the focus has become so narrow that therapeutic modalities that don’t lend themselves to the reductionist approach so as to be easily simplified for study and measurement are at worst dismissed as quackery, or at best regarded as ineffective due to contradictory results from inappropriate research approaches.

Mark Beresford considers the reductionism/holism debate in the context of medicine in this article, published in the QJM.

“Things should be made as simple as possible, but not any simpler.” Albert Einstein

This newsletter from Susan Allport describes her experiences during an experiment where she switched from consuming mostly omega 3 fats to omega 6 fats for a month. The primary effects were a reduction in her metabolic rate and deposition of half a pound of fat over her abdomen.

Susan makes some interesting points about how modern factory farming methods are altering the fat content of food that would normally be high in omega 3 fats to be high in omega 6 fats. In another newsletter she goes so far as to say that the replacement of omega 3 fats by omega 6 fats in our diets may be driving the obesity ‘epidemic’ by reference to this study on mice.

So, does this explain my beer belly?

While the bulk of my work involves treating people with musculoskeletal problems, a small but significant part of my practice is in the field of human fertility.

Some people come to me having had a medical specialist diagnose a particular functional or structural problem, but quite a few have no obvious problem that would prevent them from having a child. For those with no firm information on why they are not able to conceive, very often the crux of the problem is stress. This study, reported by the BBC, seems to support this idea, although I would argue that the duration of the stress, and not just the intensity is significant.

Stress increases our levels of sympathetic nervous system stimulation, which causes physiological changes in our bodies to prepare us to deal with a threat (freeze, flight or fight response). These physiological changes divert resources from those body systems that we don’t need to deal with a threat, so things like creative thinking, decision-making, digestive function and reproductive function can become impaired. Our neolithic bodies are designed to handle high intensity stress of short duration, but our on-demand, always on, modern lifestyles expose us to low to moderate stressors constantly so that more often than not our autonomic nervous systems are biased towards sympathetic stimulation.

Fertility treatment is a sensitive and emotive subject, and I take great care to discuss the treatment options with prospective clients before starting a course of treatment, and to explain that I am not able to help in all cases.

I follow a protocol using some Bowen technique treatments initially to address any postural or structural issues and to promote relaxation through autonomic nervous system balance. Then I introduce some acupuncture, with points selected based on a Traditional Chinese Medicine (TCM) pattern diagnosis and Body Basal Temperature (BBT) charts.

The Bowen technique stimulates the parasympathetic nervous system, initiating a balancing action throughout the autonomic nervous system, removing the sympathetic bias and allowing a degree of recalibration to take place, where the body systems that have been impaired can have a chance to work effectively.

BBT charts show the small temperature fluctuations throughout the menstrual cycle and give a good indication of how hormone levels are balanced in the follicular and luteal phases of the menstrual cycle and whether ovulation is taking place. The information from the chart feeds into the TCM pattern diagnosis to allow better point selection and timing of treatments for the individual.

In some cases, clients have found that they have become pregnant either before or just into the acupuncture phase of the treatment protocol. It would seem that for them, a little autonomic nervous system recalibration was all that was required!

For more information on the physiological effects of stress, see Robert M. Sapolsky’s book, “Why Zebras Don’t Have Ulcers”.

… is good for your health according to this study from Japan, where beneficial effects on cortisol, pulse rate, blood pressure and autonomic nervous system balance were recorded after subjects walked in a forest environment compared to an urban environment.

“It is not so much for its beauty that the forest makes a claim upon men’s hearts, as for that subtle something, that quality of air that emanation from old trees, that so wonderfully changes and renews a weary spirit.” Robert Louis Stevenson

Link to an online transcript of Janie Godfrey’s 2006 article about Bowen and Tinnitus in the RNID Focus Magazine.

Thanks to this article I have had the opportunity to work with the RNID in Northern Ireland and Belfast Health and Social Care Trust in talking about and demonstrating the Bowen technique to attendees of their tinnitus support workshops.

From my experience with tinnitus sufferers I have gained some idea of the extent of their suffering and I would encourage other Bowen therapists to work with those with this condition.

In my experience, the greatest benefit from Bowen treatment for tinnitus sufferers is the relaxation response – the autonomic balancing that Janie describes in her article. While a small number of tinnitus sufferers report a subjective change in the noise they experience, most do not, but the relaxation induced by the Bowen treatment helps to take the focus away from the noise, which is a worthwhile benefit in and of itself.

For further information about tinnitus, check the RNID site.

A study recently published in the British Journal of Obstetrics and Gynaecology is being held up as evidence that acupuncture is not effective for the induction of labour.

A look at the study shows that the authors have concluded that the acupuncture protocol they followed may not be effective. In an email to the Reuters news agency, author Uldbjerg said

“The results are very clear … Acupuncture as used in this trial does not induce labor in post-term pregnant women.”

He and his colleagues do acknowledge, however, that a “more intensive” course of acupuncture could arguably have produced different results. They also note that many acupuncturists say that to achieve an “optimal effect,” the therapy must be individualized from person to person.

The approach that I follow is tailored to the individual, but also involves some fairly intense needle manipulation to propagate the needling sensation along the Spleen channel to stimulate contractions in the uterus. The treatment is quite strong, and the recipient can be in no doubt that ‘real’ acupuncture is being used. The protocol followed by the midwives participating in the study involved some needle manipulation every ten minutes, with needles retained for half an hour.

New York-based acupuncturist Russ Stram treats elite Japanese marathoner Arata Fujiwara

Great article from Running Times, discussing the use of acupuncture to treat runners’ injuries, and perhaps more importantly as a maintenance and preventative treatment to keep them healthy and injury free. Thanks to Stephen Coughlan (runner, acupuncturist, masseur and Bowen therapist) for the link.

Most of the athletes and sport players I see come to me for help with an injury. If they were to commit to an ongoing maintenance program, they might find that their injury levels are reduced, and their performance enhanced!

New Scientist article suggests that the mechanism behind clinical depression may be more complex than a simple deficiency in serotonin levels.

Congratulations to Paula and everyone at Northern Integrative Health Practice – have a great day on Saturday!